Stroke Rehabilitation Engineering: Robotic Therapy By: Dana Demers

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Stroke Rehabilitation EngineeringRobotic
TherapyBy Dana Demers
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What is a Stroke?

• When a blood clot blocks an artery or a blood
  vessel breaks, and interrupts blood flow
• Brain cells die and brain damage occurs-up to 2
  million cells per minute
• Speech, movement, and memory are areas commonly
  affected
• Stroke is the third leading cause of death in US

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2 Types of Stroke

• Ischemic Stroke

• Hemorrhagic Stroke

• Arteries are blocked by blood clots or gradual
  buildups of plaque and fatty deposits
• 87 of strokes

• More harmful
• When a blood vessel in the brain leaks blood into
  the brain
• 13 of strokes, yet over 30 of deaths

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Introducing Robotic Therapy

• In the past, researchers believed not much could
  be done to regain brain function after the first
  few months after stroke
• Traditional care was physical therapy led by
  nurse a few hours per week
• After months of no progress, doctors and patients
  would lose hope and accept fact that nothing
  could be done

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MIT-Manus

• One of the first robotic systems for stroke
  therapy
• Created by Hermano Igo Krebs
• More intense and fast paced than traditional
  therapy

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MIT-Manus

• Uses a robotic joystick which guides the hand
• Patients see commands on a computer screen,
  resembles a video game
• One of the games requires patient to attempt to
  move toward object on screen
• If they move in the wrong direction or cant move
  at all, robot nudges to the right direction
• A different system of the Manus works by
  recording movement in order to repeatedly guide
  patient through exercise
• Is able to adjust resistance and record the
  amount of force patient is applying on their own

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MIT Anklebot

• Another robotic device created by MIT
• Similar to hand-arm devices to help aid stroke
  patients with damage to lower legs
• Goal of Anklebot was to improve balance and
  efficiency of joints and prevent further injuries

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MIT Anklebot
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MIT Research

• Researchers have proved that improvements CAN be
  made with upper body function and quality of life
  even years after initial incident
• Did this by comparing robotic therapy with human
  therapy
• Both groups worked the same amount of hours, same
  repetitive motions, and achieved the same results
• However, the long hours at that fast pace is an
  unrealistic expectation of the average physical
  therapist
• Robotic therapy is also cost efficient did not
  affect healthcare costs per patient, which can
  make it available to more people

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HWARD

• Recent study conducted by Steven Cramer in San
  Diego, California evaluated the Hand Wrist
  Assistive Rehabilitation Device
• Patient sat in front of computer monitor, hand
  secured by splint and three straps, while
  examiner used software on a separate monitor to
  control robot
• Contained joint angle sensors measure movement
  of limbs
• Gave instructions on screen, if patient couldnt
  finish motion robot would assist

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The HWARD Experiment

• Active non-assist mode when the subject does
  all the work with no assistance from the robot
• Active assist mode the robot would assist
  patient when they had trouble or could not finish
  a movement
• RESULTS at the end of the study it was shown
  that patients benefited more from the active
  assist treatment

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The HWARD Experiment
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Advantages of Robotic Therapy

• Can provide therapy for long periods of time in
  consistent and precise manner
• Can be programmed to change functions with a
  single click
• Can measure and track progress
• One day could be mass-produced, so patients can
  have them in their homes
• Telerehabilitation robot can be connected and
  supervised through the internet by human
  therapist patient doesnt have to leave comfort
  of their home